How is sciatica treated?

The goal of treatment is to decrease pain and increase mobility. Treatment most often includes limited rest (on a firm mattress or on the floor), physical therapy, and the use of medicine to treat pain and inflammation. A customized physical therapy exercise program might be developed.

Medicine. Pain medicines and anti-inflammatory drugs help to relieve pain and stiffness, allowing for increased mobility and exercise. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They include aspirin, ibuprofen (Motrin®, Advil®), and naproxen (Naprosyn®, Aleve®).

Muscle relaxants, such as cyclobenzaprine (Flexeril®), might be prescribed to relieve the discomfort associated with muscle spasms. However, these medicines might cause confusion in older people. Depending on the level of pain, prescription pain medicines might be used in the initial period of treatment.

Physical therapy. The goal of physical therapy is to find exercise movements that decrease sciatic pain by reducing pressure on the nerve. A program of exercise often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise, such as walking. The therapist might also recommend exercises to strengthen the muscles of your back, abdomen, and legs.

Spinal injections. An injection of a cortisone-like anti-inflammatory medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility.

Surgery. Surgery might be needed for people who do not respond to conservative treatment, who have progressing symptoms, and are experiencing severe pain.

Surgical options include:

  • Microdiscectomy. This is a procedure used to remove fragments of a herniated disc.

  • Laminectomy.The bone that curves around and covers the spinal cord (lamina), and the tissue that is causing pressure on the sciatic nerve are removed.

Many people believe that yoga or acupuncture can improve sciatica. Massage might help muscle spasms that often occur along with sciatica. Biofeedback is an option to help manage pain and relieve stress, which can affect your ability to cope with pain. These are referred to as alternative therapies.

What complications are associated with sciatica?

Chronic (ongoing and lasting) pain is a complication of untreated sciatica. If the "pinched nerve" is seriously injured, chronic muscle weakness, such as a "drop foot," might occur.

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